1. Feasibility of non-operative management for patients sustained blunt splenic traumas with concomitant aortic injuries.
- Author
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Huang JF, Wang CC, Shen SY, Fu CY, Hsu CP, Cheng CT, Liao CA, Kuo LW, Ou Yang CH, and Liao CH
- Subjects
- Humans, Male, Female, Adult, Middle Aged, Retrospective Studies, Splenectomy statistics & numerical data, Injury Severity Score, Embolization, Therapeutic methods, Aorta, Abdominal injuries, Abdominal Injuries therapy, Abdominal Injuries complications, Propensity Score, Vascular System Injuries therapy, Vascular System Injuries mortality, Multiple Trauma therapy, Wounds, Nonpenetrating therapy, Wounds, Nonpenetrating complications, Spleen injuries, Feasibility Studies
- Abstract
Purpose: This study aimed to elucidate the treatment approach for blunt splenic injuries concurrently involving the aorta. We hypothesized that non-operative management failure rates would be higher in such cases, necessitating increased hemorrhage control surgeries., Methods: Data from the Trauma Quality Improvement Program spanning 2017 to 2019 were utilized. All patients with blunt splenic trauma were considered for inclusion. We conducted comparisons between blunt splenic trauma patients with and without thoracic or abdominal aortic injuries to identify any potential disparities in treatment., Results: Among the 32,051 patients with blunt splenic injuries during the study period, 752 (2.3%) sustained concurrent aortic injuries. Following 2:1 propensity score matching, it was determined that the presence of aortic injuries did not significantly affect the utilization of splenic transarterial angioembolization (TAE) (7.2% vs. 8.7%, p = 0.243) or the necessity for splenectomy or splenorrhaphy (15.3% vs. 15.7%, p = 0.853). Moreover, aortic injuries were not a significant factor contributing to TAE failure, regardless of the location or severity of the injury. Patients with simultaneous splenic and aortic injuries required more red blood cell transfusion within first 4 hours (0 ml [0, 900] vs. 0 ml [0, 650], p = 0.001) and exhibited a higher mortality rate (10.6% vs. 7.9%, p = 0.038)., Conclusion: This study demonstrated that patients with concurrent aortic and splenic injuries presented with more severe conditions, higher mortality rates, and extended hospital stays. The presence of aortic injuries did not substantially influence the utilization of TAE or the necessity for splenectomy or splenorrhaphy. Patients of this type can be managed in accordance with current treatment guidelines. Nonetheless, given their less favorable prognosis, they necessitate prompt and proactive intervention., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
- Published
- 2024
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